Current Burden of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease Among US Adults, 2017-2023

Donghee Kim; Pojsakorn Danpanichkul; Karn Wijarnpreecha; George Cholankeril; Rohit Loomba; Aijaz Ahmed

doi:10.1111/apt.18501

Current Burden of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease Among US Adults, 2017-2023

Aliment Pharmacol Ther. 2025 Jan 11. doi: 10.1111/apt.18501. Online ahead of print.

Authors

Donghee Kim¹, Pojsakorn Danpanichkul², Karn Wijarnpreecha^{3

4}, George Cholankeril⁵, Rohit Loomba⁶, Aijaz Ahmed¹

Affiliations

¹ Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.
² Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
³ Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA.
⁴ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA.
⁵ Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
⁶ Division of Gastroenterology and Epidemiology, University of California at San Diego, La Jolla, California, USA.

PMID: 39797575
DOI: 10.1111/apt.18501

Abstract

Our study investigated the prevalence of lean steatotic liver disease (SLD) and its subcategories, including metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction-related and alcohol-related SLD (MetALD), and alcohol-related liver disease (ALD) among lean adults in the US. Analysing data from 2965 lean adults (≥ 18 years) from the National Health and Nutrition Examination Survey (2017-2023), we found the age-adjusted prevalence of lean SLD to be 12.8%. Specifically, the prevalence was 9.3% for lean MASLD, 1.3% for MetALD and 1.0% for ALD. Notably, within the MASLD group, significant fibrosis, advanced fibrosis, and cirrhosis were observed in 5.6%, 2.4% and 2.0%, respectively.

Keywords: MASLD; MetALD; NHANES; alcohol‐related liver disease; nonobese.